In this analysis of national CAHPS Hospice Survey data from 653,208 caregiver respondents, reflecting care received from 3107 hospices, family caregivers reported worse care experiences at for-profit hospices compared with not-for-profit hospices.
A recent CMS analysis revealed a lack of patient-reported measures in palliative care, particularly in symptom management and communication. We used a patient-centered approach to develop and test two measures for patients receiving palliative care.
Family caregivers of patients treated by more than 3,100 U.S. hospices reported worse care experiences on average from for-profit hospices across all of the domains assessed, including help for pain and getting timely care.
Previous reviews examined palliative care improvements or available measures but none explicitly on improving care experiences. We reviewed literature on improving patient and/or caregiver end-of-life care experiences.
Interviews with family members about their loved one's end-of-life care found that a majority thought he or she received the right amount of care. One in six said their family member received too little care.
Opportunities exist to improve hospice care for symptom palliation and training for caregivers when their family members are at home or in an ALF setting. Efforts to improve care for cancer patients in the NH and ALF setting are especially needed.
Hospice characteristics associated with strong performance on Hospice Item Set measures differ from those associated with strong performance on CAHPS measures. Providing professional staff visits in the last two days of life is associated with high performance in both quality domains.
Important opportunities exist to improve quality of hospice care in nursing homes and assisted-living facilities. Quality improvement and regulatory interventions targeting these settings are needed to ensure that all hospice decedents and their family receive high-quality, patient- and family-centered hospice care.
A rapidly aging U.S. population with complex care needs will likely accelerate emphasis on palliative care services. A review of palliative care research found substantial evidence to support clinical practice guidelines and was incorporated into the new edition of the guidelines.
This issue features a Q&A with Michael Rich, Soledad O'Brien, and Francis Fukuyama on the perils of truth decay, and a story on the trend toward unretirement among U.S. workers. The Voices column features Gulrez Shah Azhar on environmental refugees.
Black and Hispanic patients are more likely to receive care from poorer-quality hospices. And their family caregivers are less likely to receive the right amount of emotional and religious support in hospice care. However, caregivers of black and Hispanic patients report similar or better experiences than caregivers of white patients within a given hospice.